English as a Seco
ond Lang
guage (E
ESL) Eligibility De
eclaratio
on
Inforrmation a nd Decllaration Form
Entry re
equiremen
nts for the HSC Englis
sh (ESL) co
ourse
The Eng
glish (ESL) course may
y be studied
d by any stu
udent who has been edducated ove
erseas
or in an Australian educationa
al institution with Englis
sh as the lan
nguage of innstruction fo
or five
reliminary co
ourse.
years or less prior to commencing the Pre
This inccludes:
 students wh
hose learnin
ng has been
n interrupte
ed by period
ds away from
m education
n in
which Engliish was the language o f instruction
 Aboriginal and Torres Strait Island
der students from Indig
genous com
mmunities where
standard En
nglish is not the comm
mon languag
ge of the loc
cal communnity.
The onu
us is on students to pro
ovide evidence of theirr previous schooling.
Where it is difficult to ascertain
n the extentt to which students hav
ve been usiing English as the
ge of instrucction, entry to the coursse is determ
mined on the
e basis of a n assessment of
languag
their ora
al and writte
en language
e competen
nce.
econd Language
g
(ESL)) Eligibility Declaration must be coompleted (b
by the
An Engllish as a Se
school and the stud
dent) for an
ny student s eeking entrry to the cou
urse. This fo
form is kept by the
al.
principa
ed education
n, or little orr no formal
For a sttudent who has had a substantiallyy interrupte
educatio
on in which English wa
as the langu
uage of instruction, app
proval may be sought for up to
dded to the course ent ry requirem
ments period
d. The princcipal is required to
12 months to be ad
send a submission
n, including the completted declaration form, to
o BOSTES,, providing
udent’s indiv
vidual circum
mstances.
evidencce of the stu
1
English as a Second Language (ESL)
Eligibility Declaration
Stage 6 English (ESL) student submission
Student Number:
Student’s Name:
________________________________________________________
School/Institute:
________________________________________________________
Section 1: School background
Write the required information in the columns below. FILL IN ALL THE BLANKS. If you did
not attend school in any of these years, indicate by writing the word ‘none’ in the column.
Principals should sight evidence from the student to support the information given on this
form. This evidence could include certificates, school reports or letters from the student’s
overseas schools.
School
year
Country in
which school
was attended
Name of school attended
What was the
language of
instruction?
10
9
8
7
6
5
4
3
2
1
K
Section 2: Student declaration
Please check carefully all the information you have provided before you sign this statement.
I declare that I have checked the information provided in Section 1 and certify that these details are correct. Student’s Name: ____________________________________________________________ Student’s Signature: __________________________________
2 Date: ____/____/____ Section 3: Language proficiency assessment
This section is to be completed by the principal or English (ESL) teacher.
Please circle the appropriate rating for the nominating student on the ESL Scales below.
Oral interaction
1
2
3
4
5
6
7
Reading and responding
1
2
3
4
5
6
7
Writing
1
2
3
4
5
6
7
8
Section 4: School/Institute statement
This section is to be completed by the school/institute at which the student is enrolling in the
Stage 6 English (ESL) course.
The information supplied by the student is, to the best of my knowledge, true and correct.
The student should be enrolled in the Stage 6 English (ESL) course for the reasons below.
Comment here might include expert opinion on the student’s background and level of
language proficiency. Please attach additional sheets if required.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Teacher’s Name: ___________________________________________________________
Teacher’s Signature: ___________________________________
Date: ____/____/____
Principal’s Name: ___________________________________________________________
Principal’s Signature: ___________________________________
Date: ____/____/____
Please ensure that all sections in this application are completed and that any supporting
documentation (as appropriate) is attached.
If the school is unable to make a clear determination, this application may be forwarded to
Student Support Services on:
Fax:
Email:
(02) 9367 8087
[email protected]
3